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The Eating Instinct: Food Culture, Body Image, and Guilt in America
The Eating Instinct: Food Culture, Body Image, and Guilt in America
The Eating Instinct: Food Culture, Body Image, and Guilt in America
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The Eating Instinct: Food Culture, Body Image, and Guilt in America

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About this ebook

An exploration, both personal and deeply reported, of how we learn to eat in today’s toxic food culture.

Food is supposed to sustain and nourish us. Eating well, any doctor will tell you, is the best way to take care of yourself. Feeding well, any human will tell you, is the most important job a mother has. But for too many of us, food now feels dangerous. We parse every bite we eat as good or bad, and judge our own worth accordingly. When her newborn daughter stopped eating after a medical crisis, Virginia Sole-Smith spent two years teaching her how to feel safe around food again — and in the process, realized just how many of us are struggling to do the same thing.

The Eating Instinct visits kitchen tables around America to tell Sole-Smith’s own story, as well as the stories of women recovering from weight loss surgery, of people who eat only nine foods, of families with unlimited grocery budgets and those on food stamps. Every struggle is unique. But Sole-Smith shows how they’re also all products of our modern food culture. And they’re all asking the same questions: How did we learn to eat this way? Why is it so hard to feel good about food? And how can we make it better?

LanguageEnglish
Release dateNov 13, 2018
ISBN9781250120991
Author

Virginia Sole-Smith

Virginia Sole-Smith is a freelance journalist whose work has appeared in the New York Times Magazine, Harper’s Magazine, Slate, and Elle. She is the author of The Eating Instinct: Food Culture, Body Image, and Guilt in America and also writes the Burnt Toast newsletter. She lives in New York’s Hudson Valley with her two daughters, a cat, a dog, and way too many houseplants.

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  • Rating: 3 out of 5 stars
    3/5
    Discusses all the different ways eating can sometimes be anything other than a simple, pleasurable, nourishing experience. The impetus for the book was the author's baby born with a congenital heart defect, which required surgery and for her to be put on a feeding tube as an infant; Violet then refused to eat for many months, even after the tube should no longer have been needed. It was an arduous journey getting Violet to eat. This drove the author to examine other ways and reasons humans may not or can not do such a simple act as eating; she discusses babies with adverse reactions to milk, anorexics, severely "picky" adult eaters, people too poor to eat properly, and of course just plain women born and bred to this diet-crazy, thin-obsessed culture. It was absorbing. I'm not usually into "kid stuff," but she told Violet's story and the other baby/kid/parent stories in such a way that made even me interested.
  • Rating: 3 out of 5 stars
    3/5
    Inspired by her baby daughter's experience with a feeding disorder, author Victoria Sole-Smith examines that most basic of tasks, eating, and some of the more unusual issues that are associated with it. She profiles well-heeled ladies who feel guilty if they (or their children) eat something that isn't organic or "clean", as well as bariatric surgery veterans and African-Americans who engage in "eating while black". Self-proclaimed "picky eaters" are given their due as well. And don't even get her informants started on breastfeeding! After a while it gets wearing to read about the eating habits of strangers. The author also makes presumptuous statements about how "we" feel about food and body image issues. Recommended only for those with a strong interest in the topic.
  • Rating: 3 out of 5 stars
    3/5
    This book is a non-fiction book about eating, diet, health, culture, and eating disorders. It is well-researched, with extensive end notes. Being a rather squeamish person when it comes to medical details, I was put off by the extensive descriptions about the author's child's illnesses and medical situations. I skipped over a lot of that part of the book. I almost stopped reading it because of this, and did not feel these memoirs were necessary to the book's main points. A short introduction to the thesis of the book with reference to the child's illness would have been sufficient. I did not find anything new to add to what I already knew about this topic. I received this book from Early Reviewers, in exchange for a review.
  • Rating: 3 out of 5 stars
    3/5
    This book is an easy and interesting read for those interested in diet culture and eating disorders. For me, it focused entirely on personal stories and not enough (or at all) in any exploration of the consequences of diet culture and its relationships with and effects on sexism, racism, and classism in our culture. A superficial look at food and eating in American society.
  • Rating: 4 out of 5 stars
    4/5
    "Food is supposed to sustain and nurture us. Eaing well, any doctor will tell you, is the most important thing you can do to take care of yourself. Feeding well, any human will tell you is the most important job a mother has, especially in the first months of her child's life. But right now, in America, we no longer think of food as sustenance or nourishment. For many of us food feels dangerous. We fear it, We regret it. And we categorize everything we eat as good or bad."When her daughter was born with a heart condition, needing multiple surgeries, feeding tubes, she realized her daughter did not know how to eat, enjoy food. She felt she had failed in the most important duty of motherhood. Even once the feeding tube was removed, they had a slow journey towards regarding food as enjoyable. This prsked her interest in how food is viewed by many, and in multiple interviews she takes us through the ever changing role of what we eat.The differen dirt crazes, heslth advice that is ever changing, the emotional connection to food and the many food related illnessess. The pressure of a media that promotes thinness, a culture that thinks if one gets I'll they have not eaten correctly. Food and food related books, diets, supplements has become a mega business worth billions. it is in their favor if they can keep us off balance, constantly searching for the new and improved cure all. For many eating is no longer enjoyable, it has become challenging and pressurized. We have forgotten the instinct, and no longer listen to our body, which can and will, if we let it,ctell us when and how much to eat. Our own control has been diverted and control given over to others.Quite an informative read, well done and we'll presented.ARC from Netgalley.
  • Rating: 4 out of 5 stars
    4/5
    I really enjoyed this book! Although, I would be terrified to read it as a first-time mother. Oh the slippery-slope of having a picky-eater. I loved the author's different collections of stories, and the reasoning behind the behaviors. Its so easy to just say "oh, that person is picky" in a negative light, but this book really made me pause and think back to those moments with friends and family who wouldn't eat certain foods. At some point, it stops being choice. This book is a good reminder that are a lot of different ways to perceive the role of food in our lives.
  • Rating: 4 out of 5 stars
    4/5
    Sole-Smith’s question is simple – how do women relate to food – but the answer is complex and as far reaching as one can imagine. Through interviews with women across the socio-economic and health lines she explores this question. Interwoven is the narrative of where this question came from – her own experience with her daughter’s inability to eat.Sole-Smith is a writer by trade, not a scientist, so that must be first understood when reading this book. While she includes some science, it is important to note that this is not a book about the science of eating – but about the social and cultural challenges and connections.Pros: Sole-Smith included women from a wide range of backgrounds and made a particular point of including low-income women, whose challenges with food are unique and not often understood by the intended audience of her work. Her writing is technical enough to be fulfilling but not so dense that is reads like a textbook. By including stories and first-hand experience, she created a personal narrative that drew the reader in.Cons: Not enough science to prove her points, and she didn’t include the issue of where the diet advice women get from doctors and foundation is even correct. This seems particularly important for this subject, to me, and I found the lack of it a bit conspicuous.This book, although not perfect, was informative and sparked a few good discussions when I brought it up to friends. I would recommend this as an excellent non-fiction selection for Women’s Book Clubs – it’s a topic we all deal with and might open up good avenues of discussion and support. Note: I received this book free through LibraryThing's Early Review Program in exchange for my fair and honest opinion
  • Rating: 3 out of 5 stars
    3/5
    I received a free copy of this book in exchange for an honest review. I enjoyed the fresh perspective on eating for pleasure, and the author's reminder that enjoyment should not and cannot be separated from food intake was timely and welcome. There is also some good material here about body image, albeit no information or argument that I haven't encountered many times before.I felt that the author meandered quite a lot, tossing in "Eating While Black" seemingly just for a cute chapter title, and I couldn't quite gather exactly what Sole-Smith did recommend about food and eating--because surely eating for pleasure as much as we please isn't doing us any good and has certainly contributed to, if not caused, an obesity epidemic in this country. There is just too much cheap delicious food around, loaded with addictive salt, sugar, and fat, to take the purely hedonistic view. I came very close to putting the book down after 30 pages at the beginning about the author's baby daughter's medical problems. While I was sympathetic, I could not figure out what the long memoir had to do with the thesis of the book. The anecdote about her daughter stopped on page 32.The book would have benefited from less personal experience/anecdotal evidence and better organization of topics.
  • Rating: 3 out of 5 stars
    3/5
    A combination of memoir, reportage, and light polemic. Makes a fairly convincing case that pretty much everyone in America is eating disordered, to one degree or another. Surprisingly little emphasis on the gendered aspects of this, which seems like a super major omission. I was drawn through it quickly, but felt in the end that I had learned little and shifted my views not at all. Just because socioeconomic factors make it elitist to urge everyone to eat unprocessed food, does not mean that processed food is not bad for you. Just because some people seem to experience few health consequences (for a time!) eating nothing but junk, doesn't mean we should give up fighting against the corporate and industrial forces who are trying to promote this stuff. Piqued my interest in the intuitive eating approach and Health at Every Size movement, although frustratingly little concrete info was given.
  • Rating: 4 out of 5 stars
    4/5
    The book starts with the authors daughters eating issues after birth. From the struggles that Sole-Smith deals with takes her to look at eating and how it is viewed in America what we buy, how we eat, picky eaters, eating disorders, clean food, junk food and the toll it takes on people. there are also stories of people with various types of reading disorders and how they affect their lives.

Book preview

The Eating Instinct - Virginia Sole-Smith

PREFACE

What does it mean to learn to eat, in a world that’s constantly telling us not to eat? It’s a question I started asking five years ago, when my daughter Violet stopped eating as a result of severe medical trauma. Suddenly, we had to begin again, to forget all the normal rules about breast-feeding and spoon-feeding, and gingerly pick our way through a surreal new world where food was simultaneously the enemy and our salvation. But in many ways, this is also a question I’ve been asking my whole life, as a woman who came of age at the intersection of the alternative-food movement and the war on obesity. As a skinny kid growing up in the 1980s, I thought processed foods were great; I felt sorry for my friends whose moms bought only weird brown bread for their peanut-butter-and-jelly sandwiches. I’m not saying we never thought about healthy eating—the 1970s and 1980s also saw the birth of modern diet culture, with the rise of aerobics videos and fat-free everything. And I certainly understood that fat was bad, and that was why we bought skim milk and diet soda. But this was a more straightforward time for dieting; you joined Weight Watchers and ate SnackWell’s if you needed to get thin. You didn’t have to reject an entire food-industrial complex or introduce exotic new ingredients into your diet. Quinoa was still relegated to the dusty bin in a corner of our town’s one hippie-run health food store.

But by the time I graduated from high school in 1999, we were buying mesclun greens and whole-grain pasta. Obesity had become an official public health crisis. Carbohydrates were the new bad food, though fat was far from vindicated. We were still a few years away from the landmark publication of Michael Pollan’s The Omnivore’s Dilemma, but the conversation was beginning—on the coasts, at least—about the importance of organic farming and the need to eat whole foods instead of processed ones. As I’ll explore in the chapters ahead, these twin anxieties about obesity and about the eco-health implications of our modern food system have transformed American food and diet culture. Eating well has become wildly more complicated; it’s now about eating clean, it’s about being a socially responsible consumer and an accomplished home chef. Thinness has become our main measure of health, but also of personal virtue, of having the right kind of education, politics, and morality.

When I went to college, I got homesick, found a website that would deliver Ben & Jerry’s to my dorm room, and gained a bit more than the freshman fifteen. It turned out that being a thin child did not ensure that I would be a thin adult; I’ve spent most of my twenties and thirties perpetually in the process of losing or gaining the same forty pounds. I’m often not even aware that it’s happening; I’ll just suddenly find that, yet again, my jeans fit all wrong in one way or another. Most of the time, I live firmly in the overweight range of the body mass index scale. I’ve never been what Roxane Gay calls Lane Bryant fat, which I say not as any point of pride, but just to be clear that I’m not here to appropriate the experience of anyone who has lived in a larger body and knows firsthand the daily discrimination that brings. But my body did go from thin, to normal, to heavy-ish during a fifteen-year period when our whole culture got a lot more anxious about food and weight, when the ideal woman’s body went from merely thin, to thin and impossibly toned, capable of running marathons, pretzeling into complex yoga positions, and breast-feeding a baby all at the same time. Of course those messages have seeped into my psyche; of course they have shaped how I feel after I eat a doughnut or a salad. I’ve never had an eating disorder or even much of a propensity toward dieting. I lasted exactly two days on the one and only crash diet I tried, before running to the deli for a giant turkey sandwich. But I am not always at peace with my body. After all, I’ve never met anyone who really is.

You may be wondering what my weight and dieting history has to do with having a baby who won’t eat. But nothing connected with food happens in a vacuum. Modern diet culture doesn’t just happen to teenage girls trying to lose weight for prom. It’s influencing how all of us think about food, every day and at every meal, often in hidden and unconscious ways. This culture tells pregnant women we have to eat a certain way, and then feed our babies and young children according to unattainable standards of perfection. It draws the lines between which sorts of eating habits are normal, acceptable, and healthy, and which are unhealthy, even disordered and pathological. And it targets both men and women, though we’ll hear a bit more from women in this book, because we are still the ones held to the strictest weight and beauty standards, suffering from disproportionately higher rates of disordered eating, and feeling the most pressure around food and parenting. But diet trends do not discriminate on the basis of age, weight, race, or social class; they target each of these groups in specific and personal ways.

Recognizing when my ideas about how I should feed Violet were the product of external pressures helped me navigate the process of teaching her to eat again. I’m not sure I would have learned any of this if we hadn’t had to start all over, to figure out how to make food feel safe to a traumatized child. I’m not sure I’m done learning it now. Violet taught me that eating well cannot be about following rules; it has to be about trusting our own instincts, which value safety, comfort, and pleasure just as much as nutrition, and sometimes more. But in many ways, what we could help her overcome as a baby was only possible because she was still so young, and still very much insulated from the larger food world around us.

After I wrote a piece for The New York Times Magazine about how Violet learned to eat again, I was inundated with emails and comments from people struggling to figure out the same thing. I began talking to them and collecting their stories, some of which you’ll read in the next chapters. When you consider our most intimate physical activities, eating is somewhere just below sex, showering, and using the toilet. Yet we do it in public, all the time. By agreeing to share their stories in this book, my sources are now eating on an even larger stage. I’m grateful for their honesty; in return, I’ve changed names and omitted or very slightly altered personal details when it was necessary to respect their privacy. I’ve also respected their preferences with regard to sharing certain facts, such as weight or specific eating choices. For some people, these are empowering truths to own and share. For others, to reveal weight, in particular, is emotionally destructive. (It can also be fraught to read about someone else’s weight, so if you struggle with an eating disorder yourself, please use your own best judgment in deciding whether to read those chapters.)

Over the past two years, I’ve sat in immaculate marble kitchens and tiny, peeling-linoleum ones. I’ve visited doctors’ offices, research labs, and commercial kitchens. I’ve interviewed some three dozen people about their relationship with food, and surveyed or exchanged emails with many more. And I’ve eaten many meals—with women recovering from weight-loss surgery or eating disorders; with picky eaters and adventurous gourmands; with people who have seemingly unlimited budgets and with folks struggling to afford to keep food in the house. Their individual struggles are unique and influenced by their own particular biology, family dynamics, socioeconomic status, and idiosyncratic tastes and preferences. The resulting myriad of ways they experience food is sometimes hard to fathom if you haven’t ever met someone who grocery shops with food stamps, or who eats only french fries. But they’re all products of our modern food culture. And they’re asking the same questions that most of us have: How did I learn to eat this way? Why is it so hard to feel good about food? And how can I make it better?

One

Nothing by Mouth

September 17, 2013. It is the day before my daughter Violet’s one-month birthday. It is also the first day that she will almost die.

It is a day I’ll always pause on, in the years to come. Mostly I’ll remember strange, flash-frozen details: The receptionist’s stricken face in our pediatrician’s office as paramedics bustle us out to an ambulance. A respiratory technician in the emergency room shouting that he can’t go help another patient because I have a very sick little girl here. Trying to catch up to the clatter of heels running ahead of us down a long hospital hallway as they race our daughter’s crib away. They said we’d have time to kiss Violet good-bye before they took her to the operating room. I’m mad that they’re rushing. I don’t understand that it’s because, suddenly, there is no time.

But sometimes I’ll remember something else about this day, and it’s the thing that’s most important to the story you’re reading now. September 17, 2013, is also the day when Violet stops eating. And she won’t start again, not in any meaningful way, for almost two years.

I don’t realize any of this when Dan and I wake up a little after seven a.m., blinking and disoriented from an unexpected six-hour stretch of sleep. I groggily remember going into Violet’s room when she cried sometime after midnight. I put her to my breast, but she was asleep again before she could latch. I put her back down; I was asleep again before I could think about when she’d last eaten, or whether that was normal for a newborn. We are all so tired. This is having a new baby, we think.

Now, Violet is still sleeping, so I pump to relieve the pressure in my breasts and we stumble around, making coffee and breakfast. We have her four-week well-baby visit this morning and we need to hurry because we overslept, not expecting our newborn to let us do that. When she wakes up, Dan brings her to me to feed at the dining room table. She latches for a minute, and then pulls off, frustrated and sleepy again. Is it weird she isn’t eating? I ask Dan. She slept so long, shouldn’t she be starving? We don’t know. We don’t really worry. Everything has been fine. This must be fine, too.

Right from birth, Violet cried when she was hungry, slept when she was full. When awake, she stares at us intensely. When she sleeps, she sleeps a lot—one night, a few days ago, for nine hours. That next morning, I texted Michelle, the nurse practitioner we see at our pediatrician’s office, because she is also my friend from yoga. She is a peaceful, comforting presence, the perfect ballast to what I know will be my paranoid new-mom tendencies. You just got lucky! she assured me. What a great baby! my friends say. Their children were fierce with colic and rage in the newborn months, and they are jealous that I’m getting to sleep. So I don’t worry. Breast-feeding is fumbling and slow; Violet’s latch hurts, a pain I feel all the way down to my toes. I use a nipple shield even though the lactation consultant tells me not to get dependent on it; when I go to her nursing circle, she stands over us and jams Violet’s head onto my breast, and it works. You’re getting it, she says. Keep in touch. I feel relieved when Michelle tells us that Violet has regained her birth weight at her two-week checkup. The time we’re spending on breast-feeding sessions starts to drop, from forty-five minutes to twenty, then ten, then five; I think the two of us are just getting better at it.

We aren’t.

This morning, when we finally stumble in to the four-week well visit, a nurse puts Violet on the baby scale and we see that she has somehow lost half a pound. She once again weighs less than the seven pounds, nine ounces she measured at birth. Michelle comes in laughing. That can’t be right! But she weighs Violet again and it is. Then she inspects the purplish tinge of Violet’s lips, feet, and fingernails. I think she’s cold, but I have a hat in the diaper bag; I am prepared. Michelle lets me get the hat, while she calls downstairs for a cardiologist. I ask why. She’s dusky, Michelle says. She is still calm, but she doesn’t lie to me. That means something is wrong. She knows that Violet’s heart is failing.

After that, information comes more quickly than I can grasp. The oxygen level in Violet’s blood is only 75 percent of what it should be. By the time we’re in the ambulance, lights flashing as it heads down the Taconic Parkway toward Maria Fareri Children’s Hospital in Valhalla, New York, it’s at 60 percent. I report this to my stepmother when she calls my cell phone; I am not worried, because the EMTs are relentlessly cheerful and making jokes about how we keep getting to pass cops. Mary tries to sound not worried for me, but I can tell she is scared. She worked in hospitals for years as a physician assistant. She has seen people die when their oxygen dropped so low. I don’t know yet that every red blood cell in your body must have an oxygen molecule securely attached; that when less than 80 percent of them do, your body starts to shut down. That Violet’s body is shutting down. In the pediatric intensive care unit, Violet is put on a ventilator, the breathing tube snaking down her throat before she’s fully sedated. Even with the machine breathing for her, her oxygen keeps dropping. By the time they are running her away from us, she’s at 20 percent. In the catheterization lab, a cardiologist threads a catheter into Violet’s heart, inflates a tiny balloon, and tugs, punching a hole through her interatrial septum to release a gush of pent-up oxygenated blood. This is the first time we break Violet to save her.

The next day, we begin to learn how several rare congenital defects have made Violet’s heart incompatible with life, as one doctor gently puts it. Violet is missing her mitral valve and part of her ventricular septum; her left ventricle is smaller than it should be, and her aorta and pulmonary artery have traded places. These kinds of problems are known collectively as single ventricle physiology. They cannot be repaired, but a cardiothoracic surgeon can cut apart veins and arteries and sew them back together in a life-sustaining pattern over the course of three open-heart surgeries. When the process succeeds, Fontan circulation, as the result is known, enables a child to reach a healthy, if heavily monitored, adulthood.

What the doctors cannot tell us, what we can’t begin to grasp as we sit in the PICU on Violet’s one-month birthday, waiting for her to breathe on her own, is that as difficult as the cardiac diagnosis is—and always will be—it won’t be what dominates our daily lives in the months ahead. Violet not eating is merely collateral damage, a side effect of this much bigger, all-consuming problem. But it will consume us, especially me. Her feeding tube will be a constant reminder of this day and all the hard days ahead. It will tell the world that we have a sick child.

Eating is fundamental to human existence. It’s the primary work of mothers and babies; the basis of every holiday and communal celebration; the first thing most of us do when we wake up in the morning. In the hospital, a patient who cannot (or must not) eat is referred to as NPO; the abbreviation stands for nil per os, Latin for nothing by mouth. A child who takes nothing by mouth isn’t participating fully in human life. It makes people wonder what else she can’t do; it focuses us on her limits, instead of her potential.

I worry, on that first day and the next, in an idle, abstract way, about whether Violet is hungry. I understand intellectually that she’s on a ventilator, that feeding is impossible, but my heart hasn’t caught up yet and I keep thinking, "Arent I supposed to feed her? Is this hospital not very pro-breast-feeding?" It doesn’t register that my breasts don’t hurt. By the time they race Violet away from us, it has been almost ten hours since I pumped and tried to feed her. I should be engorged, leaking. But I’m not. My body already knows that it is not needed. That my baby has stopped eating.

At some point, while we’re waiting for Violet to live or die, a nurse brings me a breast pump and a bag of clear plastic breast-milk containers. I am intimidated by how many there are; a dozen two-ounce vials with snap tops. Maybe I’ll pump tomorrow, I think. I’d rather just feed her directly, I tell the nurse. She kindly explains that Violet can’t eat right now because she doesn’t have the energy. This is also what had been happening during those shortening feeds over the past two weeks—she was too oxygen deprived to suck, swallow, and breathe, the trifecta of skills essential to infant feeding.

Once she’s been stabilized, our doctors are determined that Violet regain the half pound lost while she was dying, so she’s given a feeding tube almost as soon as she comes off the ventilator. The nurse inserts a nasogastric tube into Violet’s nose, and then pushes it down her esophagus and into her stomach. The tube is connected to a feeding pump beside Violet’s clear plastic bassinet. I begin pumping as well, cloistered in a windowless room down the hall that the PICU reserves for this purpose. The hospital’s breast pump is mint green and waist-high. Its analog dials look like eyes. When it stares at me, I think of wacky robot characters on failed 1980s sitcoms. Back in our hospital room, I hand over my half-filled vials apologetically. The nurses must mix them with formula to make enough food for Violet. They run this cocktail through the feeding tube every three hours, pushing as many calories as possible into Violet whether she’s awake or asleep.

Violet undergoes her first open-heart surgery a week later. This time, I’m not the only one to assume that breast-feeding will resume soon after Violet comes off her second ventilator. Everyone expects it. But she continues to tire so quickly that the doctors figure she’s burning more calories trying to eat than she can possibly take in. So a second nasogastric tube goes in, this time with very little deliberation. We’re calling it the NG tube now. We know what NPO means. We’re getting the lingo down. But: It’s a temporary measure, they assure us. Just till she gets her strength back. We think she will be eating normally within two weeks.

Instead, we are discharged after twenty-two days in the hospital and go home with the NG tube still in place. Before leaving the hospital, we run Violet’s noon tube feed under the proud supervision of the nurses who have spent the past week training us to use the equipment just the way they do. Then I dress Violet in a purple onesie patterned with pink hearts. I bought it especially for our hospital departure day, paying too much for it while shopping online during one of my many pumping sessions. She screams when I pull the soft cotton over her head; we haven’t figured out yet that anything near Violet’s face terrifies her and that we need to switch to outfits with zippers or snaps. We tuck Violet into her car seat, which Dan carries into the elevator, swinging it gently to make her smile. In the hospital driveway, as we transfer the car seat into the back of our secondhand Subaru, Violet throws up all of the formula she has just been fed. The car is already packed and running; we are desperate to go home. We clean her off, throw the soaked onesie into a plastic grocery bag, and drive.

But now we have a new problem. Tube feeding makes Violet vomit. For most of the next year, she will throw up four to seven times a day. Babies spit up, we are told. But this is something more. The vomit can slip out silently, or it can choke Violet, turning her little face purple with the effort of getting it out. For an hour after every tube feed, we are afraid to hold her in case the slightest jostling triggers her reflux. She spends most of her day swaddled and frozen in her bouncy chair or crib. We spend our nights with two baby monitors on our pillows, one of us leaping out of bed as soon as we hear the first cough. The chronic vomiting makes us even more desperate for Violet to eat by mouth—and it also makes that goal feel even less attainable. So every three hours, we circle through the same dance: First I try to get Violet to nurse. Next, Dan offers a bottle. Every three hours, we try bottle or breast, all the while taking detailed notes to record how long she latches on, or how many milliliters she swallows. It’s never more than a teaspoonful. Every three hours, we try this most fundamental act of parenthood. And fail.

The day I stop breast-feeding is a rainy Saturday in early November. Violet is now nine weeks old. It’s a quiet morning; I shuffle around in my glasses and yoga pants, the obligatory new-mom uniform. Violet plays on an old red quilt, batting at a stuffed tomato on her play gym with ferocity while I fold the laundry. She coos whenever I make faces at her. I sing songs and kiss her toes. Other mothers have told me how maternity leave can drag: all those endless days alone with a newborn. But our morning passes quickly, maybe because we’ve been alone so rarely in her short life, half of which has now been spent in a hospital. Or maybe it’s because the doctors have emphasized the importance of adhering to Violet’s feeding schedule; she must be fed every three hours, because she’s still recovering from that first heart surgery and every calorie is critical. The breaks between feedings feel too short for me to accomplish more than one item on my To Do list. At 11:55 a.m., with half the laundry still crumpled in its basket, I set up my nursing pillow, unfasten my nursing bra, and make sure I have the stopwatch on my iPhone ready to time.

Violet grins when I pick her up. But as soon as I turn her into position—the football hold that I’ve practiced under the supervision of lactation consultants, feeding specialists, and nurses—her little face changes. She begins to scrabble against me, yelling and turning her head away to push her face into the friendly woodland print on the pillow. I change to a different hold. I shift the angle of her head, my elbow, my shoulder. I sing more and I talk to Violet, explaining that she’s okay, that this eating business is supposed to be a good thing. Then I start to cry too. I cry because it isn’t working, and everyone said it would be by now. I cry because Violet’s refusal to eat is so opaque, so absolute, that it defies adult logic and explanation. And I cry because when I start to match her desperation, when I start to want to kick and scrabble back, instead I hold her head and force my breast into her mewling little mouth, until she shrieks louder and begins to gag and sputter. I remember the lactation consultant jamming Violet’s tiny head into place. I want to think that this is the same, that this is normal. But I know my heart is racing too hard and I’m feeling a dangerous kind of fury.

And so I stop. I put Violet in her bouncy seat and bounce her until she is quiet. I’m sorry, I’m sorry, I’m sorry, I say as I bounce, until we are both calm and slightly hypnotized. We’re done. We’re done now.

Then I take the long, skinny tube that dangles out of my baby’s nose and connect it to a purple plastic feeding pump mounted next to her bouncy seat, which I’ve already loaded with precisely 84 milliliters of formula-fortified breast milk. The pump beeps and whirs, Violet drifts off to sleep, and I sit on the floor of my living room while, once again, a machine feeds my child.

*   *   *

Because babies begin nursing in the first hours of life, because the cry of hunger is one of our first communications with the world, it’s widely assumed that eating is our most primitive instinct. This is not quite correct. Breathing is the first thing we do after birth, and perhaps the only behavior more fundamental to our survival. But hunger is instinctual. And so is satiation. We are born knowing to cry, root, and seek when we feel hunger, and to stop when we are full. But while these behaviors are innate, they are also surprisingly fragile, in need of constant reinforcement. A baby cries, a breast or bottle is offered, and the baby sucks and swallows until she feels better. Most newborns do little else in their first few months, until their ability to eat is finely honed and the feeding relationship between parent and child is thoroughly established. In this way, the instinct to eat isn’t just a need for physical nourishment—it also ensures that babies form secure attachments. It’s how they fall in

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